Updated Standards for Protocols: Physicians and ARNPs

In Florida, an Advanced Registered Nurse Practitioner (ARNP) is defined by s. 464.003, Florida Statutes, as “any person licensed in this state to practice professional nursing and who is licensed in an advanced nursing practice, including certified nurse midwives, certified nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists, and psychiatric nurses.”

A written protocol signed by all parties, representing the mutual agreement of the physician or dentist and the ARNP may include the following:

(a) General Data.

1. Signatures of individual parties to the protocol (At practice locations where multiple physicians or dentists are supervising the same ARNPs, the practice may delegate to one of the supervising physicians or dentists the authority to sign the protocol for the physicians or dentists listed on the protocol);

b. Name, address, license number, and DEA number of the physician or dentist;

2. Nature of practice, practice location, including primary and satellite sites; and

3. Date developed and dates amended with signatures of all parties.

(b) Collaborative Practice Agreement.

1. A description of the duties of the ARNP.

2. A description of the duties of the physician or dentist (which shall include consultant and supervisory arrangements in case the physician or dentist is unavailable).

3. The management areas for which the ARNP is responsible, including

a. The conditions for which therapies may be initiated,

b. The treatments that may be initiated by the ARNP, depending on patient condition and judgment of the ARNP,

c. The drug therapies that the ARNP may prescribe, initiate, monitor, alter, or order.

4. A provision for annual review by the parties.

5. Specific conditions and a procedure for identifying conditions that require direct evaluation or specific consultation by the physician or dentist.

464.012(3), F.S. An advanced registered nurse practitioner shall perform those functions authorized in this section within the framework of an established protocol which must be maintained onsite at the location or locations at which an advanced registered nurse practitioner practices. In the case of multiple supervising physicians in the same group, an advanced registered nurse practitioner must enter into a supervisory protocol with at least one physician within the physician group practice.

The Nurse Practitioner who applies for a DEA registration should be prepared to submit a copy of the protocol via email or fax after the DEA has contacted you.